Increased ICP

Question 1

HEAD INJURY:

if a patient has a head injury, what do you always assume?

What do you want to do with the body’s position?

keep slight traction in the head and neck, but when can we release the traction? why?

how can you tell CSF from other drainage?

Answer 1

that a c-spine injury is present until proven otherwise (by doing an Xray)

• keep it in perfect alignment
• when the doc gives his orders. because muscle spasms can occur and cause a lot more trauma
• it will be positive for glucose

Question 2

HEAD INJURY:

since this patient will be on mucho steroids, why would we need to increase nutrition?

what kind of environment do they need? why?

can they get an NG tube?

Answer 2

• steroids break down a lot of protein and fat
• quiet; noise can induce seizures
• no; will increase cranial pressure

Question 3

what is normal ICP?

Answer 3

5 - 15

Question 4

since ICP varies according to positions, what do we do to the H.O.B?

Answer 4

Elevate it

Question 5

S/S of INCREASED ICP;

Earliest sign=___

Speech?

Respirations?

drowsiness?

mood?

reflexes?

Answer 5

• change in LOC
• slowed or slurred
• gradual rise= pattern change; fast rise= stop breathing (cheyne stokes or ataxic)
• increased
• subtle change in mood
• absent reflexes

Question 6

what are cheyne stokes respirations and ataxic respirations?

Answer 6

Cheyne–Stokes respiration is an abnormal pattern of breathing characterized by progressively deeper and sometimes faster breathing, followed by a gradual decrease that results in a temporary stop in breathing called an apnea. ataxic= fast breathing then short period of apnea

Question 7

TREATMENT:

Osmotic diuretics do what in the brain?

why is lasix often given with osmotic diuretics?

before you give someone an osmotic diuretic make sure what 2 organs are working?

why would hyperventilation be used?

Answer 7

• pull fluid from the brain cells
• osmotics just pull the fluid from the cells and put it in the vascular space which puts the patient in a fluid volume excess risk.
• heart and kidney (since the heart’s workload has increased due to the increased blood volume).
• hyperventilation makes you alkalotic and causes brain vasoconstriction which decreases icp

Question 8

what kind of vomiting should you expect?

Answer 8

projectile

Question 9

Decerebrate=

decorticate=

which one is worst?

when someone starts posturing, why would the doc want to order tube feedings immediately?

Answer 9

• away from the body
• towards the body
• decerebrate
• tense muscles burn a lot of calories